thyroid

[quincydavis]

my mother had thyroid operation in 1966 since then she has been on thyroxide tablets 100mg, this was increased recently to 125mg. She was admited into hospital for unrelated treatment and without any notification they reduced the dosage to 25mg, since then she has become extremely tired and has aggresive mood swings. Can anyone advise us as to whether the medication change would have this effect.

[yogasun]

I am not a medical person, Sqad is your man but that seems like a drastic reduction of thyroxine (?) and I am sure the mood swings etc would be a result of that.

[Sqad]

Yes, the unexplained reduction in her thyroxine could explain the mood swings and aggression.

My advice:

1) Ask for a reason that the dose of Thyroxine was reduced.
2) Ask if she could have blood tests for T3,T4 and TSH

Unless there is a very good reason which is not apparent, then I would consider the reduction in Thyroxine......... reprehensible.

[ladyalex]

Sorry to hijack this thread with another question, but is there any reason why hospital doctors often seem to alter long-standing medication ?
This has happened to me more than once.....or rather it has happened to elderly relatives of mine. Once they have been left in hospital, they are at the mercy of the hospital staff who change medications and either don't explain the reasons for it , or explain the reasons for it to a patient who has no hope of either understanding or passing on the information to their relatives.
My elderly father had his long, long standing prescription of amitryptiline completely cut off and in due course (a fortnight to the day) became very depressed again. As he was on a general ward, most of the staff thought that he was just being curmudgeonly until I figured out what had happened and got them to re-instate it.
What a nightmare , particularly for my poor old Dad who aged 80+ didn't know what had happened to him.

[Sqad]

ladyalex

///Sorry to hijack this thread with another question, but is there any reason why hospital doctors often seem to alter long-standing medication ?///

I have no idea........inexperience of the doctors?

[ladyalex]

Sorry, more of a rant than a question really.
I think you must be correct...note to self...do not allow yourself to become ill enough for hospitalisation in August or February...or have they changed the 'new intake' dates now ?

[Sqad]

ladyalex....LOL

[marie26]

With regard to the Thyroxine, there has obviously been an error in the transcribing of the drug dose from the GP prescription to the hospital prescription. The ward staff will appreciate you letting them know this and they can get the correct dose restarted. This does occasionally happen to some patients, but it is generally picked up within about 24 hours (with us anyway) by the ward pharmacist, who checks all new patient charts with their GP and dispensing chemist, or by the relatives informing the ward staff. Sometimes, some drugs have to be stopped because of interactions with treatment, or because the current drug may be the reason for admission to hospital.

The junior medical staff all change in August, and rotate every 4 months through their specialties, but the senior staff eg Registrars and Nurse Practitioners attached to the teams make the whole 'change' process much less stressful for everybody, not least the patient.

[boxtops]

That's awful ladyalex - I was on amytripline for a time many years ago, and the instruction was that under no circumstances should I stop it, only cut back by half a tablet, stabise, cut the next half, and so on. I;m so sorry for the way your dad must have felt.

[askyourgran]

I usually take a 5mg water tablet each morning. When I was in hospital they stopped my tablet because my blood pressure was low, quite right too, but it made me wonder how would I know (apart from being dizzy) that my bp was too low to stop taking the tablet that day at home? I was also being prescribed a strong painkiller at the time, so perhaps this may have interfered with my usual medication too.

[Sqad]

Marie 26, I empathise with your response and it is well put, however we are discussing the abrupt cessation of "long standing" medication which usually implies anti depressants,hormone replacements and anti rheumatic medication.

Drug interaction, as you pointed out, is very important.

An explanation should be given to the patient as to why his/her long term medication had been stopped.

Rotation of HP/HS's every 4 months.........and here lies part of the problem.
The day to day running of the wards is performed by the Junior Staff who rotate every months and not the Registrars who very rarely if ever, clerk the patient into the ward on admission. Junior staff at one time rotated every six months which gave a more personal medical attention to the patient and the "change over" less frequent.

[marie26]

I do know what the discussion is about, and I provided one reason why the dose of thyroxine may have been mis-prescribed. There are, of course, many other reasons why this may have occured. In my experience patients are given an explanation as to why a medication dose is altered, but there are exceptions unfortunately.

[dothawkes31]

I've been on 2 x 50mcg of thyroxine since 1988, well the first 6 months i think it was a lower dose but the upped it. I have never changed from that and have annual blood tests which would pick up if i needed it changing, but I never have, if the changed my dose so dramatically i would probably react badly, as I understand thyroxin has an instant effect on your system.